Impact of Telehealth on Medical Billing Practices

What’s the Impact of Telehealth on Medical Billing Practices in 2024?

Last updated on April 6th, 2024 at 05:20 am

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Telehealth, or the provision of medical services digitally, via a variety of communication technologies, has well and truly taken off in recent times. It’s been catalyzed by the proliferation of technology and demand for more accessible healthcare into a phenomenon that has indeed changed the way patients receive assistance and communicate with their providers. As a result, transformative changes in the field of medical billing ensued. Here’s an overview of the state and the effect of telehealth per practice and the ability of the best medical billing companies to meet your needs in the light of these revolutionary changes.

1. Changes in Reimbursement Policies

The use of telehealth by an increasing number of clients has encouraged changes by policymakers and insurance carriers to their reimbursement protocols. Insurance carriers quickly increased their coverage of telehealth services in response to the COVID-19 epidemic, lowering compensation rates in equivalent procedures. However, there are still shifts and complications in the telehealth payment model. Multiple alterations will continue to be made at the national and state levels. Medical billing firms will need to be organized and well-versed in the procedures to obtain the right compensation for practices.

 2. Coding and Documentation Challenges

Since the telehealth visit must be accurately represented in coding and documentation to demonstrate the nature of the service and to substantiate billing, medical billing companies are required to have healthcare providers apply the CPT and modifiers specific to telehealth in their medical billing . Due to billing and coding requirements, extensive documentation is critical to establish medical necessity and support claims processing. It will be the responsibility of the billing company to provide the necessary guidance to healthcare providers to ensure proper documentation and coding processes.

3. Compliance with Regulatory Requirements

Telehealth also presents several novel compliance factors concerning patient privacy and security and licensure implications. Medical billing companies need to verify that telehealth services are consistent with privacy and security requirements set forth in the Health Insurance Portability and Accountability Act regarding safeguards for patient health information. They also need to confirm that healthcare providers who supply telehealth services implement professional licensure necessity and legislation on medicine practice choice across state boundaries . As such, medical billing companies have a critical role in guaranteeing that telehealth services are provided in line with statutory requirements to prevent penalties and liabilities.

4. Integration with Practice Management Systems

Streamlining billing workflows necessitates the integration of telehealth platforms with practice management systems. In some situations, medical billing companies may be required to develop partnerships with telehealth tech companies to incorporate billing functionality directly into the telehealth platform. This entails enabling real-time eligibility verification, claims submission, and reimbursement tracking, among other things, into the telehealth platform to reduce the pressure on administrative workers while also implementing strong billing processes. Alternatively, a medical billing business that employs completely integrated billing platforms may simply configure the billing process to real-time submissions.

 5. Revenue Cycle Management Optimization

Telehealth creates opportunities to optimize revenue cycle management, such as increased claims processing speed and a decrease in accounts receivable days. Medical billing companies may use automation and technology-based approaches to expedite claims filing, adjudication, and payment posting for telehealth services . Furthermore, proactive denial mitigation and appeals planning are required to reduce revenue leakage and enhance reimbursement for properly conducted telehealth appointments . By enhancing RCM processes, medical billing companies, can improve healthcare institutions’ revenue and financial performance while reducing fraud and abuse.

Conclusion

In conclusion, the growing prevalence of telehealth has led to important changes in how medical billing is done, as well as to a variety of new opportunities and challenges for practitioners and medical billing companies to consider. The compliance requirements are complex, and medical billing companies help healthcare providers stay ahead of their likely risks. The best medical billing companies will help healthcare providers achieve success in complex compliance by staying existing on the latest regulatory requirements related to pay or repayment, coding, and documentation and implementing technology-driven solutions that advance time-saving and revenue cycle process optimization so that healthcare providers can dedicate themselves to what is most important: providing high-quality, patient-centered care on site or from afar.